MEDICARE: DAJAH DENISE COATES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	6801121208	MI

General Provider Information

NPI Number	:	1326691544
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAJAH DENISE COATES

Provider Business Mailing Address
First Line	:	PO BOX 595
Second Line	:
City	:	WAYNE
State	:	MI
Zip	:	48184-0595
Country	:	US
Telephone Number	:	248-841-0448
Fax Number	:	833-740-4255

Provider Business Practice Location Address
First Line	:	33150 SCHOOLCRAFT RD STE L4
Second Line	:
City	:	LIVONIA
State	:	MI
Zip	:	48150-1631
Country	:	US
Telephone Number	:	888-717-2102
Fax Number	:	833-740-4255

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/17/2019
Last Update Date	:	02/08/2026

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